Determination of Glucose-Independent Racial Disparity in HbA1c for Youth With Type 1 Diabetes in the Era of Continuous Glucose Monitoring
Authors' conclusion
Young B patients have clinically relevant higher average HbA1c at any given level of MBG or TIR than W patients, which may pose an additional risk for diabetes complications development. HGI ≥ 0.5 may be an easy way to identify high-risk patients.
Study context
- Population
- Healthy youth with T1D using factory-calibrated continuous glucose monitoring (CGM); age 14.7 ± 4.8 years, M/F = 51/67, diabetes duration 5.4 ± 4.7 years
- Participants
- 33 vs 85
- Exposure
- Non-Hispanic black vs non-Hispanic white youth with T1D
- Bn = 33
- Wn = 85reference
- Outcome
- HbA1c adjusted for MBG, age, gender, insulin delivery method and race by percent sensor use interaction
Main finding
As reported in the abstract
Average HbA1c adjusted for MBG, age, gender, insulin delivery method and race by PSU interaction
P < 0.0001
Observational data: associations, not effects.
Further findings
Unadjusted glycaemic measures
- B had higher unadjusted HbA1c, mean blood glucose (MBG), MBGSD, glucose management index (GMI) and hemoglobin glycation index (HGI) than W
- Time in range (TIR) and percent sensor use were lower for B
- Time below range was similar for both
HbA1c with TIR substituted for MBG; predicted MBG
- Higher HbA1c persisted in B when TIR was substituted for MBG
- Predicted MBG higher in B at any level of percent sensor use (PSU)
Hemoglobin glycation index (HGI)
- 95th percentile of HGI in W
- 0.47
- B with HGI ≥ 0.5
- 52%
Original publication
Determination of Glucose-Independent Racial Disparity in HbA1c for Youth With Type 1 Diabetes in the Era of Continuous Glucose Monitoring. J Diabetes Sci Technol. Published 12 September 2023. doi:10.
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